Even in the ICU, physicians are starting to speak up about when too much is too much.

My intensivist colleagues joke about the Intensive Care Unit (ICU) being the "Expensive Care Unit," as some of the most sophisticated tests and treatments are employed here, for patients clinging to life. When it comes to saving a life, no effort is spared. It is about doing everything possible to turn around a difficult situation.

Many of the interventions they provide are life-changing, usually for the better. Patients who've experienced terrible traumas, overwhelming infection, or cardiac arrests all benefit from the expertise of critical care teams. In the ICU, miracles do happen. And sad things happen too.

Sometimes no matter how much effort or time is put in, it isn't enough. At other times, that same effort would best be focused on making a person in a futile situation as comfortable as can be, ushering them gently rather than violently to whatever is next.

The Toronto Star explores this world through the eyes of Dr Andrew Baker, the Critical Care Chief at St Mike's hospital in Toronto. Dealing with life and death keeps doctors human, reminding us to cherish our own lives and the people in them.

His job, he says, is to guide families to understand that using increasingly critical interventions, when there’s no reasonable expectation of avoiding death, takes away a person’s dignity. “Pain and harm is really what we’re trying to avoid.”